An exploration of parenting needs in war and refugee situations Aala El-Khani Rachel Calam Fiona Ulph School of Psychological Sciences The University of Manchester

The role of the family during displacement Primary caregiver- ‘protective shield’ or further complicate war stress? (Elbedour et al, 1993) Family cohesion is a significant predictor of refugee children’s mental health (Fazel et al 2012, Lancet) Family violence is a strong predictor of change in a child’s mental health; improved family life working to protect and increased conflict associated with intrafamilial violence

Using family skills approaches Family and parenting skills have a key role in improving children’s wellbeing now and in the future Prevention of emotional and behavioural difficulties, drug misuse, violence and crime Adapting to needs, cultures and contexts

Can this approach help displaced families?

Phase 1 Recruitment areas: Syria and Turkey 8 semi-structured interviews carried out exploring parents experience of parenting in war and refugee situations and focusing on what support families need/want 2 inside a refugee camp tent 6 inside a refugee camp school 8 mothers

Logistical collaboration with an NGO

Challenges in data collection Following standard ethical guidelines in this situation greatly limited the sample size Interviewer often only had contact with parents once due to the nature of the refugee camps Very difficult to use a standard method of informing participants at least 24hrs before consent Difficulties in accessing refugee camps El-khani et al (2013). Ethical issues in research into conflict and displacement. The Lancet, 382, 764-765.

Phase 2 Recruitment: Syria and Turkey 4 focus groups, with 19 mothers Carried out inside parent tents 2 interviews with professional aid workers; One camp doctor and one project manager of an international NGO Interviews were audio recorded

The parenting challenges of displaced families

Parenting challenges in refugee situations Environmental specific challenges Child specific challenges Parent specific challenges

Environmental challenges Camp/living condition stressors “I don’t like them far, how do I know what they are doing? Everything is new here. How can I balance giving them freedom I know they need with keeping them safe? It’s very hard” Barriers to accessing support Lack of basic essential needs

Child specific challenges Behaviour changes “They are spitting and hitting and shouting and using bad words. Sometimes I can’t believe these are my children, we all say this. They are very bad now” Emotional challenges and signs of trauma “They cry at night, they scream a lot while they are sleeping. They are very angry. They have so many unanswered questions that I do not know how to answer”

Parent specific challenges Loss of control “I can not control anything around me. We are living each second unaware of what’s coming next. You asked me what it’s like to be a mum now, well this is it, it’s like we are not mums, we are just keeping kids alive by feeding them and making sure they are alive and safe” Parents own emotional challenges “I shout at him ‘enough! come on you must stop looking sad’. I know before you say that’s all wrong, what else can I do?”

Maladaptive discipline techniques “I hate hitting them (children). I really hate it. Especially as they have been through a lot of hard things..I wish I knew how to be more in control of my feelings like I was before, to know how to do the right thing”

Key messages There is a crucial need for family skills training to support parents/caregivers who are displaced due to war and conflict Despite all the traumas of displacement, parents are motivated to be the best parents they can be We need to identify cost-effective ways of delivering such programs to these displaced families Aala.el-khani@postgrad.manchester.ac.uk Rachel.calam@manchester.ac.uk Fiona.ulph@manchester.ac.uk